personalized service - for doctors

Ugh, don't want to sound like a massage service, "We offer that personal touch" (wink wink). I'm just daydreaming, I mean brainstorming: How to beat the MTSOs, even on a small, micro-business scale. What does a typical doctor in his or her typical practice need as far as medical documentation? How can we do that better than an MTSO, or even self-serve EMR?

The lady who mentioned in another post having a typing speed of 200 wpm, "fast as someone could talk" (wow) made me start thinking. Those of us who do have really good speed (not the meth kind), could take dictation as fast as the doctor dictated. He or she could stand there and watch as it was input onto the screen. The doctor still has to dictate somehow-- from his perspective, it's the same whether it's done by VR or regular typing. The transcriptionist-on-the-scene would offer definite benefits: Instant gratification to offset the monotony of dictation (doc speaks words, sees them instantly appear on screen); and ability to correct input immediately, on either side. It would be a bit of a throwback to the old days of "Miss Smith, please come into my office and take a letter."

Any delay in dictating from the doctor's perspective (having to slow down, repeat something) would be offset by having the immediate, finished, 100% accurate product there immediately; and that little extra "kick" of seeing it happen before his or her eyes.

Not sure about the scheduling of all this; some doctors dictate after every office visit, often right in front of the patient. Others make notes during each visit, and do the dictation all at once at the end of the day.

At the large clinic where I used to work, the transcription department was decimated by the arrival of EMR. The doctors were expected to input all their own information to the EMR during the patient visit. They had problems with this (severely split attention, navigating menus while trying to take in patient complaints), so medical assistants were assigned to follow the doctors from room to room and handle the EMR duties. Somehow, the medical assistant approach to EMR didn't quite work satisfactorily either; but I'm not sure why, as I was forced out of my job completely by that time due to entire days with no work.

I still feel that there MAY be some niche for the personal-secretary approach to medical transcription. Yes, we have all said, at one time or another, in response to a doctor's requests transmitted over our earphones-- "I am not his personal secretary!" But that may be a way for us to survive. To be marketable, we would have to have top-notch, cracker-jack skills and speed, so it is not for everyone.

We would have to approach the doctor with the option to tailor-make our job description around what he or she needed, and with the understanding of what level of availability we would need to maintain. (Following doctor from room to room, or taking all the dictation at the end of the day, or at various times during the day; but just BEING there when needed, much like a nurse or medical assistant or any other medical office personnel.) Would each doctor have his or her own transcriptionist? All questions to be decided...

We need to find out what the doctors need, and provide that, and exactly that. There must be some area of dissatisfaction or room to improve services that only the doctors are aware of, which we need to find out, and which could be the perfect job niche for us. For all of us who have seen our standardized job description and pay made into a joke by the developments of the last decade, this is the time we need to create our own job description, and go hit the pavement and sell the skills and talents we have to offer. Doctors' offices have always generated jobs as a side effect, and employed local workers. Why should it be different now?

To summarize: Doctors don't like dictating (boring chore, have to re-live patient visit a second time, hard to remember details after seeing 5 or 15 other patients, no instant feedback from speaking into a phone or recording unit). They don't like reviewing their dictation (re-living the patient visit for a THIRD time). They don't like seeing their sentences mangled into nonsense by a transcriptionist who doesn't have a good instinctive sense of English usage.  They certainly don't like fielding a call from a patient who has seen their colleague, who has left town for the weekend, and finding a big blank spot in the record where the information hasn't been transcribed yet.  They don't like forking out big bucks for transcription that comes back late and/or full of mistakes. (Hey, they don't like forking out big bucks for transcription that is fast and accurate, either.) Many of the doctors don't like "fooling with the EMR." 

Is the doctors' experience with MTSOs an entirely positive one? The MTSOs do not address many of the problems above.

What do we as (really good) transcriptionists have to offer as a solution for all of this? How can we make ourselves like cellphones? (You know-- you lived perfectly happily without them for decades, but now that they are here, you can't live without them.) It's called a "created need." We just didn't *realize* that we needed cellphones. They are a good thing. We need to make doctors realize that we are so convenient, and offer so much for the money, that they can't live without us!

Also, it's good for us-- no more isolation. The doctors have been dictating into a void, we have been transcribing into a void.

Now, I feel encouraged. And, to put my money where my mouth is, I am going to go make the rounds of the local offices, and test my theory against reality, and see just what part of this will hit the fan, and what turns out to be a good idea!

(Another thing-- doctors' offices, unlike hospitals, are much freer to add staff at will.)